AQUACEL FOAM 420637

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a distributor,foreign,health pr report with the FDA on 2019-05-23 for AQUACEL FOAM 420637 manufactured by Convatec Inc.

Event Text Entries

[145972144] Based on the available information, this event is deemed to be a serious injury. Additional patient/event details have been requested but not provided to date. Should additional information become available a follow-up report will be submitted. (b)(4).
Patient Sequence No: 1, Text Type: N, H10


[145972145] It was reported the "aquacel inside of foam cannot absorb exudate properly". The dressing was reported to be changed every third day which end user alleges led primarily to maceration as well as necrosis that occurred on a small wound area. The treating physician noticed a change in the wound but, was unable to confirm when the change occurred. The patient did not have any serious problems that required medical treatment other than debridement of the affected area. Per the information provided, the end user has multiple wounds with multiple dressings used from multiple lots. The total amount of dressings related to the maceration and necrosis is still unknown. Photographs of the product were provided.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1049092-2019-00198
MDR Report Key8637356
Report SourceDISTRIBUTOR,FOREIGN,HEALTH PR
Date Received2019-05-23
Date Mfgr Received2019-04-24
Date Added to Maude2019-05-23
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactMS. JEANETTE JOHNSON
Manufacturer Street211 AMERICAN AVENUE
Manufacturer CityGREENSBORO NC 27409
Manufacturer CountryUS
Manufacturer Postal27409
Manufacturer Phone3365424681
Manufacturer G1CONVATEC INC
Manufacturer Street211 AMERICAN AVENUE
Manufacturer CityGREENSBORO NC 27409
Manufacturer CountryUS
Manufacturer Postal Code27409
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameAQUACEL FOAM
Generic NameDRESSING,WOUND,HYDROPHILIC
Product CodeNAC
Date Received2019-05-23
Model Number420637
Lot Number2658597
Device AvailabilityN
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerCONVATEC INC
Manufacturer Address211 AMERICAN AVENUE GREENSBORO NC 27409 US 27409


Patients

Patient NumberTreatmentOutcomeDate
10 2019-05-23

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